Heidi Hagemeier / The Bulletin

A new initiative is launching this month at the Community Pharmacy at St. Charles Bend to help better stabilize patients with serious mental health issues, saving money for both the patients and the hospital in the process.

Medical professionals will soon begin distributing a special prescription pad to psychiatrists and primary care providers that lists two generic drugs, risperidone and olanzapine. When a physician writes a prescription with the pad, the patient can take it to the St. Charles Bend pharmacy and receive a 30-day supply for free.

The idea, said Derek Gillespie, St. Charles Bend’s director of pharmacy, is to offer more affordable options for mental health patients on medications known as atypical antipsychotics. These types of drugs are typically used to treat schizophrenia, bipolar mania and other disorders, according to the federal Agency for Healthcare Research and Quality.

By lowering the prescriptions’ cost, the hope is these patients will not stop taking their medication when budgets get tight.

Josh Bishop, director of health services and government programs for the insurer PacificSource, said the generics are considerably more affordable than the brand equivalents, which often cost hundreds of dollars per month. The generics cost a fraction of that, depending on the dosage.

Physicians sometimes try to help patients with medication costs by giving them samples of a name-brand drug. But once the samples run out, some patients have trouble affording the prescription.

“What’s been happening is mental health patients were getting started on (name-brand) medications that they really couldn’t afford to take long term,” Gillespie said. “So after their initial supply would run out, they would go to get their prescription filled at a pharmacy and they would discover that the cost of it was prohibitive. Then they would stop taking the medication.”

Once off the medication, he said, mental health episodes bring them back to area clinics and emergency rooms.

“Some of these individuals may have been through that cycle many times,” Gillespie added.

The prescription pad is an effort of the Central Oregon Health Council, an organization that is working on various aspects of health care reform in the region.

Both Gillespie and Bishop serve on a council subcommittee that is looking specifically at psychopharmacology.

Gillespie said the subgroup about a year and a half ago started discussing ways to deal with the cycle of mental health patients who go on and off their medications.

The subgroup’s initial idea, he said, was to give physicians samples of the two generics to distribute as they would name-brand samples. But legal hurdles made that unworkable.

Next, the group turned to the prescription pad idea. Gillespie said the concept of dispensing medication at no cost isn’t new, but he isn’t aware of another organization targeting physicians with prescription pads.

The hospital pharmacy intends to educate the patients when they come in to get the prescriptions filled, Gillespie said.

A component of that discussion is what the generic drug is likely to cost after the free 30-day supply runs out.

Another benefit of the program for patients, he said, is that they can determine whether the drug is effective for them at no cost.

“A lot of times with a first month’s prescription it either won’t work for the patient or they have side effects that cause them to discontinue taking the medications,” he said. “In this case, they’re not out a bunch of resources for that trial.”

Gillespie said it’s uncertain how many patients will take advantage of the program. The subgroup and hospital will evaluate it as it goes forward.

Bishop said that if utilized, the program could improve the health of patients and lower health care costs.

“We will definitely see a community benefit,” he said. “We can keep them out of the ER. We can keep them out of the hospital.”